title: Distal quadricepsplasty in children: 88 cases of retractile fibrosis following intramuscular injections treated in Benin.
abstract: BACKGROUND
  Retractile fibrosis of the quadriceps (RFQ) is a physical and social handicap in children, and often results from a past history of quadriceps intramuscular injection. The aim of this study was to evaluate the therapeutic results of RFQ treated by distal quadricepsplasty using a modified Thompson-Payr procedure (DQPMTP).
  
  
  OBJECTIVE
  Functional recovery will be good with DQPMTP.
  
  
  METHODS
  This is a descriptive retrospective 10-year study from 2002 to 2011, including 74 children (88 knees) less than 15 years old, admitted for RFQ and treated in Benin. The types of RFQ were: knee flexion loss of motion 16 cases (18.2%), lag of extension 54 cases (61.4%) and associated genu recurvatum, 18 cases (20.5%). Wasting of the thigh was found in all cases. An associated distal femoral osteotomy was performed to correct a bone deformity in 18 cases (20.5%).
  
  
  RESULTS
  There were 16 cases (18.2%) of poorly looking postoperative scars and 2 cases (2.3%) of fracture during physical therapy. Mean flexion ROM after surgery was 77.7°. Mean flexion increased from 77.7° to 108.5° following postoperative rehabilitation or a mean gain of 30.7°. The quadriceps muscle testing scores were at least 3/5. Results of DQPMTP were good in 80.7% of cases, as shown by mean active knee flexion of 108.5° with normal active extension. The results were satisfactory in 17 cases (19.3%).
  
  
  CONCLUSIONS
  DQPMTP has the advantage of cutting a minimum of blood vessels, thus limiting the risk of hematoma. Laterally placed incisions create less tension reducing the risk of skin necrosis. The clinical and radiological results of this series confirm those in the literature. Treatment of RFQ by DQPMTP provides satisfactory functional rehabilitation in patients, which confirms our hypothesis.
  
  
  METHODS
  Level IV, retrospective study without comparison.
authors.affiliation: Clinique universitaire de chirurgie pédiatrique/CNHU-HKM, 02 BP 8229, Cotonou, Benin. Electronic address: michfiogbe@yahoo.fr.
authors.forename: M-A
authors.initials: MA
authors.lastname: Fiogbe
authors.forename: A S
authors.initials: AS
authors.lastname: Gbenou
authors.forename: E R
authors.initials: ER
authors.lastname: Magnidet
authors.forename: O
authors.initials: O
authors.lastname: Biaou
mesh_terms: D000293:Adolescent; D001541:Benin / Q000453:epidemiology; D002648:Child; D005260:Female; D005355:Fibrosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007273:Injections, Intramuscular / Q000009:adverse effects; D008297:Male; D009135:Muscular Diseases / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D052097:Quadriceps Muscle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013848:Thigh; D016896:Treatment Outcome
keywords: Child; Plasty; Quadriceps contracture; Retractile fibrosis of the quadriceps